Transurethral electrovaporization vs transuretheral resection of prostate for the management of benign prostatic hyperplasia: a comparative study at pims, Islamabad, Pakistan

ABSTRACT

To compare and determine the safety and efficacy of transurethral electrovaporization of prostate [TUVP] over transurethral resection of prostate [TUR.P] for management of benign prostatic hyperplasia [BPH]. This comparative randomized clinical study was carried out in Pakistan Institute of Medical Sciences [PIMS] Islamabad, Pakistan from May 1997 to April 1998. One hundred patients with signs and symptoms of benign prostatic hyperplasia were selected from Urology out patient department of Pakistan Institute of Medical Sciences [PIMS] Islamabad, Pakistan. They were divided into two groups of fifty each; one group underwent TURP and other TUVP. Post operative follow ups to assess the results of both the procedures were carried out at 2, 12 and 24 weeks. For approximately the same size of prostate, the mean operation time [39.7 mins] was longer for TURP as compared to TUVP [25.22 mins]. The hemorrhage was more with TURP. Clot retention incidences were five in TURP as compared to none in TUVP. The mean volume of irrigation fluid used during operation [7.5 liters] was far less in TUVP as compared with what was required in TURP [12.0 liters]. The changes in sodium and hematocrit were monitored by taking pre and post operative blood samples. The variations in the levels before and after TUVP were negligible, while TURP group patients were noted to have post operative hyponatremia. The maximum post operative stay was 3 days in TUVP [mean 2 days] compared to 7 days in TURP [mean 6 days]. As far as post operative complications were concerned, infection and perforation incidences were more in TURF compared to TUVP. Although TURP is much effective gold standard for treating BPH, it is a bit costly with higher morbidity and complication rate as compared to TUVP which is a minimal invasive technique suitable for smaller sized prostate in high surgical risk patients